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South Dakota rates for HCPCS 22862

Revision including replacement of total disc arthroplasty (artificial disc), anterior approach, single interspace; lumbar

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,137.96 / $4,365.16 / $5,623.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,819.70 / $2,187.76 / $4,073.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,715.35 / $4,897.79 / $6,165.95
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,630.27 / $3,548.13 / $5,011.87
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,041.74 / $3,467.37 / $16,595.87
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,801.89 / $4,365.16 / $4,466.84
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,801.89 / $3,801.89 / $4,570.88
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,398.83 / $3,715.35 / $4,570.88
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,606.93 / $6,606.93 / $6,606.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,238.72 / $3,801.89 / $6,025.60
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,570.88 / $5,370.32 / $5,623.41